Summary:“You know you have joined the human race when you plant a tree under whose shade you will never sit,” Greg Simon, moderator and President of FasterCures said, opening the panel with this Amish quotation.
The People First panel focused on the linkages between scientific discovery, the increasing importance of complex technological infrastructure, interdisciplinary research and individual incentive. Underlying the discussion was an appreciation for improving quality of life. The panel quickly moved to tactical concerns over how to attract and leverage the human capital that underscores the nobler long-term goal of improved care.
A crisis has emerged around the time frame and payoff associated with a career in the field of bio-medical research. David Baltimore remarked, “We are in something of a crisis, a crisis of the training process. If we want someone who is willing to jump from where the problem is to where it is going, they must be independent.”
Panelists agreed that the prerequisites for a successful career in bio-medical research involves so many years of training that the student stage of life has become “professionalized,” extending into one’s mid-30s. Individuals spend more time building their CVs and lining up benefits than taking risks. According to David Agus, this process has a huge impact on risk-taking and creativity in bio-medical research, since there is “no way to swing to the fences until your thirty-five.” Agus went on to compare the lure of near-term paydays in fields like technology with the much longer term paybacks inherent in a career in the bio-medical field.
Panelists debated possible solutions that would preserve the role of individual contribution—which all see as vital to new discovery—while promoting team-based, inter-disciplinary cooperation. At the heart of this debate is how tenure qualifications can coexist with cooperation—cooperation within labs, cooperation between small and large labs, and cooperation between clinicians and academics. Currently, tenure and as a corollary, professional prestige, depend upon publishing. As a result, PhDs are reluctant to take second billing on a team project. In addition, those who touch the patients—the doctors—are removed from those who touch the research. Salary concerns in a field plagued by grant reductions and patient cost cuts are not provided with the economic incentive to intermingle.
If biomedical research is to improve, collaboration must take the form of interdisciplinary cooperation (e.g., between industry and university), project collaboration (e.g., PhDs who sacrifice publication recognition to work on a team), and lab cooperation (e.g., Big Pharma companies with the computational resources working with smaller labs focused on one therapeutic discovery).
Anna Barker believes that a new reward system is required; one that preserves individual contribution that “changes the world,” but integrates more of a team-based system. She suggested introducing a reward system for interdisciplinary publications. David Baltimore advocates creating a nontenure track for team players who are compensated with higher pay. He would create a professional track (i.e., capitalistic rewards) and an academic track (i.e., more traditional academic rewards).
Gordon Binder supports a similar solution, mentioning financial support from large pharma companies like Amgen for post-doc fellowships. Ernie Bates pointed out that Johns Hopkins has tried to address the issue by creating joint physician/scientist programs. While students typically opt into basic research or clinical study early on, joint programs like the one at Johns Hopkins provide exposure to both. All panelists agreed that it will be critical to integrate computation and biology, and provide infrastructure for smaller labs to compete with the bigger companies.
The nature of research projects has changed, as the FDA has raised the bar on new drug approvals, the pharma/biotech industry has nearly tripled in size, and technology and computational biology have increased the infrastructure required to churn out new drugs, new regimens and new hope. Cooperation is the key word, yet the old system, which promotes the individual and the big company, remains in place. In the long run, the panelists are hopeful that we will experiment with new incentives and modes of cooperation to lure human capital into the system and provide the most effective results geared toward improving the quality of others lives.
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